Provider Demographics
NPI:1578767745
Name:DIRAMIO, ERIC M (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:M
Last Name:DIRAMIO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4184 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3051
Mailing Address - Country:US
Mailing Address - Phone:716-674-0434
Mailing Address - Fax:
Practice Address - Street 1:4184 SENECA ST
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3051
Practice Address - Country:US
Practice Address - Phone:716-674-0434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009942-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC09942-6WOtherWORK COMP
NYX009942-1OtherNY LICENSE
CC4932Medicare ID - Type Unspecified
NYU84390Medicare UPIN